- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $3,008.00 / $6,483.00
| Facility | | $1,582.00 | $3,008.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.67 / $959.59 / $2,065.00
| Facility | | $775.67 | $959.59 | $2,065.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $208.11 / $384.81 / $384.81
| Facility | AS | $208.11 | $384.81 | $384.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,499.00 / $4,486.00
| Facility | | $966.00 | $2,499.00 | $4,486.00 |